Prompt Kyphoplasty Not Crucial for Osteoporotic Vertebral Fx

Three-week trial of conservative treatment beneficial; treatment outcomes similar at one year

MONDAY, Oct. 8 (HealthDay News) -- For patients with osteoporotic vertebral compression fractures (OVCFs), kyphoplasty can be successfully performed following failure of a three-week trial with conventional treatment, with both treatments resulting in similar outcomes at one year, according to a study published online Oct. 1 in The Spine Journal.

Hwan Mo Lee, M.D., Ph.D., from Yonsei University College of Medicine in Seoul, South Korea, and colleagues compared clinical outcomes for patients who underwent conservative treatment or kyphoplasty for OVCF. A total of 259 patients with one or two acute painful magnetic resonance imaging-confirmed OVCFs were prospectively enrolled. All patients underwent conservative treatment in the initial three weeks. For 91 patients who complained of sustained back pain and disability, kyphoplasty was performed. Two hundred thirty-one patients completed the one-year follow-up: 82 in the kyphoplasty group and 149 in the conservative treatment group.

The researchers found that about 65 percent of patients were treated successfully with conservative treatment. Older age (older than 78.5 years), severe osteoporosis, being overweight, and larger collapse rates were risk factors for conservative treatment failure. In both groups, at each follow-up assessment there were significant reductions in the visual analog scale for pain scores and in the Oswestry Disability Index. Better clinical outcomes were seen at the first month in the kyphoplasty group, but there were no significant differences in outcome measures between the groups at three, six, or 12 months.

"Given these results, prompt kyphoplasty should not be indicated in the case of a patient with OVCF that has no risk factors for failure with conservative treatment," the authors write. "Rather, a trial of conservative, three-week treatment would be beneficial."